Knowledge is Power – A Definitive Guide to Staying Healthy On the Road

Staying heathyIn order to enjoy your trip in a maximum way staying well and healthy should be your M.O. Not to kill the nostagia, but a sunset just isn’t the same when you doubled over in pain from that fish taco you had for dinner. Of course a stomach ache is peanuts compared to other menaces lurking out there in the exotic twilight.

To assist you in the battle of the virus, with a little help from Dr. Dobrow at Safe Treks, I’ve prepared a guide to help you define and hopefully avoid some of the more widespread heath risks out there.

The first order of business is to make sure to protect yourself from getting sick before you get sick. A ounce of prevention is worth a pound of cure, so they say.

Immunizations

When traveling internationally, be sure your immunizations are up to date. Some countries require proof of immunization for entry. The most common one to require documentation is the yellow fever vaccine. Many international travelers get immunized for Hepatitis A and B as well.

If you’re unsure of what immunizations you’ll need for your particular trip, the best idea is to check with the experts at Center for Disease Control who’s wisdom can be found online at www.cdc.gov. The CDC should be your go-source for inoculations info and also what anti-malarial requirements might exist for the countries you’re visiting. The CDC also lists health hazards for different world regions—a resource your doctor may even turn to for advice about health needs for your destination choices.

If you’re not sure what reservoir, swamp or jungle you’ll end up being close to, most major cities have special travel health clinics to get immunizations, advice and information locally. If that’s not available to you, your primary doctor can also assist you by email or phone.

Here’s a handy chart of vaccination schedules.

Getting sick

Insects

Mosquitoes are a menace. Possibly the most annoying of all insects, they also transport disease, cause painful, itchy welts and generally irritate the hell out of people. Insect repellant can be an absolute lifesaver in places where mosquitoes exist. Take it from me, there’s nothing more likely to kill a good mood than a swarm of these flying vampires. When traveling outside of the city, it’s always a good idea to keep at least a small bottle of repellant on your person at all times. You never know where you’ll encounter standing water and inevitably these little buggers. The best application technique I’ve found is the spray-on method. This provides the easiest method and most coverage, especially on those hard-to-reach body parts. Repellant can save you from other dangerous insects as well.

Here’s a run-down on what’s best in terms of repellant products, defense and application. (Spoilier: it’s DEET)

Insect Repellants

Most experts agree that insect repellents containing DEET (N,N-diethylmetatoluamide) are the most reliable and long-lasting. DEET repels mosquitoes, ticks, and other arthropods when applied to the skin or clothing.

  • DEET formulations 30- 50% are recommended for both adults and children over 2 months of age.Deet
  • When using sunscreen, apply sunscreen first and then repellent.
  • Wear long-sleeved shirts, long pants tucked into socks, and hats to cover exposed skin.
  • Inspect your body and clothing for ticks during outdoor activity and at the end of the day. Wear light-colored or white clothing so ticks can be more easily seen.
  • Apply permethrin or other insect repellents, to clothing, shoes, tents, mosquito nets, and other gear for greater protection. Permethrin-treated clothing is effective for up to 5 washings.
  • Be aware that mosquitoes that transmit malaria are most active between dusk and dawn. Stay in air-conditioned or well-screened housing, and/ or sleep under an insecticide treated bed net.

Insects & The Diseases They Transmit

  • Fleas: Plague, Rickettsial Fevers, Tunga penetrans
  • Flies: Leishmaniasis, River Blindness, Ricketssial Fevers, African Sleeping Sickness
  • Kissing Bugs: Chagas Disease
  • Mosquitoes: Chikungunya, Dengue, Filariasis, Japanese Encephalitis , Malaria, Yellow Fever
  • Ticks: Lyme Disease, Tickborne Encephalitis, Viral Hemorrhagic Fever

Find out more about the insect-borne illnesses MalariaTyphoidYellow Fever,Dengue FeverHepatitus AHepatitus B.

But wait, the PLAGUE?! Oh man.

Diarrhea

The most common illness you’ll face on the road is likely to be traveler’s diarrhea, (aka, Montezuma’s Revenge). With different food options available than you’re used to, it’s pretty much inevitable that you’ll have to deal with an upset stomach at some point on your trip.  Avoiding uncooked and unpeeled fruits and vegetables might help increase your chances of staying diarrhea free, but if you do get sick, dehydration is the major danger. Make sure to rest and drink lots of water! If you’re sick for more than a day or two, seek medical attention.

Travelers’ diarrhea is the most common illness affecting travelers. Each year between 20%-50% of international travelers, an estimated 10 million people, develop diarrhea at some point.

Avoiding Traveler’s Diarrhea

  • Boiled or bottled water only, no ice
  • Cooked foods only, piping hot
  • Cooked vegetables only
  • Peeled fruits only, peeled by you
  • Avoid foods prepared by street vendors
  • Avoid unpasteurized dairy & cheese

Treatment of Traveler’s Diarrhea

  • Antibiotics are the principle elements in the treatment of traveler’s diarrhea.
  • Antimotility agents (Imodium, kaopectate) provide symptomatic relief, and serve as useful adjuncts to antibiotics.

Another way to avoid a diarrhea illness is to simply wash your hands. Do it on a regular basis with soap and water or use an alcohol based hand gel (at least 60% alcohol). This could be the difference between having a sickness-free trip or bailing early due to something unforeseen in your gut.

The Sun

The sun can be your best friend and your worst enemy. Though it may not be the most dangerous illness that can befall you, it is important to your health in the long run. It’s as simple as this: bring your sunscreen everywhere you go and use it. Be judicious on how often and how much to use. Base it on your level of exposure. In the mountains, snow can amplify the amount of UV radiation you’re exposed to. And don’t forget, even on overcast days a sunburn is still possible.

Since sunburn and skin cancer is universal these days, you should be able to find sunscreen quite ubiquitously in countries where fair skinned people exist. In central and eastern African nations sunscreen may be scarce so look to large local pharmacies, airports or tourist shops. Stock up—on a safari you may not find any for days.

The Feet

Comfortable shoes are a must-have if you’ll be doing a lot of walking, which, unless you’re royalty, you probably will. Bring at least one pair of thick-soled shoes or boots. Cobblestones will ding your tender little heels in no time, not to mention the perils of spontaneous trekking. You may be fooling yourself thinking you can get by with a simple pair of sandals your entire trip.

Sex & Sexually Transmitted Diseases

AIDS and other STDs are the most common serious illnesses sexually active travelers encounter on the road. In countries where prostitution and sex tourism make up a large part of the local economy, you should be very cautious and always always use protection when indulging. Contraceptives may not be available locally, so don’t forget to pack your Willie Warmers!

Traveling with medication

You should always bring more than enough regular-basis medication on a trip, ideally more than you need to last you throughout your journey. Or, if they’re given to you in a limited supply, set up a location where you can have the meds shipped. Make sure you carry them in the original pharmacy packaging, and also bring the written prescription if you have it. If there’s any doubt whether the drugs were prescribed legally, you’ll have your proof.

If you’re traveling with vitamins, make sure you carry them in their original packaging as well. Transporting pills or medicine in unnamed containers will inevitably raise suspicion when passing through airport security, causing you easily avoidable hassle and delays.

Much of this information was brought to you by Dr Robert L Dobrow, MD of Safe Treksin San Francisco. Dr. Dobrow has a Certificate of Travel Health from the International Society of Travel Medicine. For questions or his advice, he can be reached at 415-750-6510 or by email at HubbarE@sutterhealth.org.

* image credit Exothermic